Respiratory Pathology Lab 1: Upper Respiratory Tract. Shannon Martinson,

Transcription

1 Respiratory Pathology Lab 1: Upper Respiratory Tract Shannon Martinson,

2 Case 1 Signalment: 5 year old dog History: 2 month history of nasal discharge Decreased airflow from left nasal passage Rhinoscopy and biopsy done twice at monthly intervals inflammation Radiographs frontal sinus opacity

3 Case 1

4 Case 1 Description On section of the head, there is a ~ 3 x 4 cm, poorly demarcated, white-tan, firm mass, invading and effacing the left nasal conchae and filling the nasal cavity. The mass invades the nasal septum.

5 Case 1 What type of disease process is this? Neoplasia Morph Diag Malignant neoplasia, left nasal cavity

6 Case 1 What are some differentials for this lesion? Epithelial Nasal adenocarcinoma Undifferentiated carcinoma Squamous cell carcinoma Mesenchymal Fibrosarcoma Chondrosarcoma Osteosarcoma Round cell Lymphoma Mast cell tumour Granulomatous rhinitis may also be a differential! Morph Diag Malignant neoplasia, left nasal cavity How would you achieve a diagnosis? Histology!

7 Case 1 What are the typical clinical signs with nasal neoplasia? Epistaxis Nasal discharge Craniofacial deformity Neurologic disease if brain invasion occurs What are possible sequelae? Local invasion Can invade through the cribiform plate to the brain Metastasis LN, lungs, etc

8 Case 2 Signalment: 9 year old Thoroughbred gelding Clinical History: 2 3 month history of nasal discharge Endoscopy: Abnormalities in the guttoral pouches Right laryngeal paralysis Dysphagia and weight loss over the last month

9 Case 2

10 Case 2 Description Covering large portion of the right guttural pouch mucosa are thick clumps and sheets of friable tan material

11 Case 2 Morphologic Diagnosis Fibrinonecrotizing eustachitis (right side), multifocal to coalescing, severe, subacute to chronic

12 Case 2 Etiology Aspergillus spp (fumigatus) Guttural pouch mycosis (= Etiologic Diagnosis)

13 Case 2 How could you confirm your diagnosis? Cytology Histology Fungal culture PCR Etiology Aspergillus spp (fumigatus) Guttural pouch mycosis (= Etiologic Diagnosis) PAS stain

14 Case 2 Sequelae Erosion of the carotid artery fatal epistaxis Cranial nerve deficits (Cr N 7, 9, 10, 11, 12) Cerebral infarction Can you relate the clinical signs to the lesions? Damage of the right Cr N 9 (glossopharyngeal) difficulty swallowing dysphagia Damage of Cr N 10 (vagus) pharyngeal/laryngeal paralysis Dysphagia and Right laryngeal paralysis Exudate drains into nasopharynx nasal discharge

15 Case 3 Signalment: month old steer Clinical History: Bought 330 animals in the fall 2-3 animals died over 7-10 days Froth at mouth/nose, difficulty breathing, die

16 Case 3 Description In most areas, the nasal mucosa is dark red to brown with multifocal to coalescing adherent plaques of yellow friable exudate

17 Case 3 Description The tracheal and laryngeal mucosa are red-brown and diffusely covered by adherent plaques of yellow friable exudate

18 Case 3 Morph Diagnosis Fibrinonecrotizing rhinitis, tracheitis, and laryngitis, extensive/diffuse, acute (subacute), severe Possible Etiology BoHV-1* +/- BPIV-3, BRSV + secondary bacterial infection Disease Name = Infectious Bovine Rhinotracheitis Diagnostic testing Submit tracheal/nasal swab (antemortem) Submit fresh nasal/tracheal tissue (postmortem) Virology FAT, PCR, viral isolation Bacteriology routine culture

19 Case 3 Which may account for mortality in these steer? Sequelae of rhinitis Sinusitis Laryngitis Pharyngitis, Otitis Lymphadenitis Bronchopneumonia

20 Case 4 Signalment: Multiple pigs, various age groups, M and F Clinical History: Multiple animals in the herd have epiphora, sneezing, and/or distorted faces with deviated snouts

21 Case 4 Normal Description The nasal turbinates are variably misshapen with widening of the nasal meatuses, and in some cases, deviation of the nasal septum and /or a complete loss of turbinates. Morph Diagnosis Rhinitis, with turbinate degeneration/loss, chronic, mild to severe Disease Name? Atrophic Rhinitis Etiology? Multifactorial Toxigenic strains of: Bordetella bronchiseptica* Pasteurella multocida* Other contributing factors: Nutritional, management and Husbandry factors Further tests? Bacteriologic culture

22 Case 5 Signalment: 8-9 month old ram lamb Clinical History: Moist cough Mild dyspnea Found dead suddenly

23 Case 5

24 Case 5 Description Adhered to the ulcerated laryngeal mucosa is an irregular, thick, plaque-like layer of friable yellow exudate The right side is more severely affected than the left

25 Case 5 Morphologic Diagnosis Fibrinonecrotizing laryngitis, multifocal (locally extensive), chronic, severe

26 Case 5 If this was a calf: Etiology Fusobacterium necrophorum Disease Name Necrotic laryngitis = Calf diphtheria Predisposing Factors? Viral infection (BoHV-1) Iatrogenic (balling gun) Excessive vocalization FYI - in sheep these lesions may be due to : Necrotic laryngitis (like calves) or Laryngeal chondritis Diagnostic testing Laryngeal swab or tissue Bacteriology difficult - anaerobic culture! Testing for underlying viral infection?

27 Case 5 If this was a calf: Etiology Fusobacterium necrophorum Disease Name Necrotic laryngitis - Calf diphtheria Diagnostic testing Sequelae? Asphyxiation exudate blocks airway Pneumonia exudate is aspirated Sepsis / toxemia Laryngeal swab or tissue Bacteriology anaerobic culture Testing for underlying viral infection?

28 Case 6 Signalment: Two year old ewe Clinical History : Poor doer- thin body condition Trouble chewing cud Green froth present at the mouth No response to antibiotics or anthelminthics

29 Case 6

30 Case 6 Description Arising from and replacing the ethmoid turbinate is a fleshy tan-brown irregular mass measuring approximately 10 x 8 cm. It largely occludes the caudal nasal cavity and extends into the nasopharynx

31 Case 6 Morph Diag Nasal (ethmoidal) adenocarcinoma Disease Enzootic Nasal Tumor (Enzootic ethmoidal carcinoma) Etiology Enzootic nasal tumor virus (ENTV) Further tests Histology PCR, FAT, EM etc

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